Surgical stapling apparatus including buttress attachment via tabs

ABSTRACT

An apparatus for joining two hollow organ sections with an annular array of surgical staples includes a staple cartridge component, an anvil component, a buttress component and a fastening member. The staple cartridge component includes a plurality of surgical staples arranged in an annular array. The anvil component is movable relative to the staple cartridge component between spaced apart and approximated positions to adjustably clamp the organ sections between the staple cartridge and anvil components. The buttress component is configured and dimensioned to be positioned on a distal surface of the staple cartridge component. In particular, the buttress component includes a buttress member and a plurality of circumferentially arranged tabs extending proximally from the buttress member. The fastening member is configured and dimensioned to engage the plurality of circumferentially arranged tabs to securely position the buttress component on the staple cartridge component.

BACKGROUND

1. Technical Field

The present disclosure relates to a surgical instrument for applyingsurgical fasteners or staples to body tissue, and more particularly, toa surgical buttress for use with an end-to-end anastomosis staplingapparatus.

2. Background of Related Art

Anastomosis is a surgical joining of separate hollow organ sections.Typically, an anastomosis procedure follows surgery in which a diseasedor defective section of hollow tissue is removed and the remaining endsections are joined. Depending on the desired anastomosis procedure, theend sections may be joined by either circular, end-to-end orside-to-side organ reconstruction methods.

In a circular anastomosis procedure, the two ends of the organ sectionsare joined by means of a stapling instrument, which drives a circulararray of staples through the end section of each organ section andsimultaneously cores any tissue interior of the driven circular array ofstaples to free the tubular passage. Typically, these instrumentsinclude an elongated shaft having a handle portion at a proximal end toactuate the instrument and a staple holding component disposed at adistal end. An anvil assembly including an anvil shaft with attachedanvil head is mounted to the distal end adjacent the staple holdingcomponent. Opposed end sections of the organ to be stapled are clampedbetween the anvil head and the staple holding component. The clampedtissue is stapled by driving a plurality of staples from the stapleholding component so that the ends of the staples pass through thetissue and are deformed by the anvil head.

In use, one end section of the organ is secured about the anvil assemblyand the other end section of the organ is held in place adjacent thestaple holding component. The shaft of the anvil assembly is removablyconnected to the instrument. Once the anvil shaft is secured to theinstrument, the anvil is drawn into close approximation to the stapleholding component. The instrument is then fired to cause the staples topass through tissue of both sections of the organ and deform against theanvil. During the firing step, a circular knife is advanced to cuttissue inside the staple line, thereby establishing a passage betweenthe two sections of the organ. After firing, the instrument is typicallyremoved by withdrawing the anvil through the staple line, after whichthe surgeon will carefully inspect the surgical site to ensure a properanastomosis has been achieved.

While circular staplers are helpful in a number of surgical procedures,problems such as anastomotic leak, tear of tissue during staplerextraction, bleeding, and other complications may arise. In order toremedy such problems, buttress or reinforcing materials have beenutilized. However, due to the inherent difficulty in positioning andsecuring such materials with the instrument, there is a continuing needfor buttress material and buttress material and instrument combinationsthat can be safely and effectively positioned within staple cartridgeand/or anvil.

SUMMARY

In accordance with an embodiment of the present disclosure, there isprovided an apparatus for joining two hollow organ sections with anannular array of surgical staples. The apparatus includes a staplecartridge component, an anvil component, a buttress component, and afastening member. The staple cartridge component includes a plurality ofsurgical staples arranged in an annular array. The anvil component ismovable relative to the staple cartridge component between spaced apartand approximated positions to adjustably clamp the organ sectionsbetween the staple cartridge and anvil components. The buttresscomponent is configured and dimensioned to be positioned on a distalsurface of the staple cartridge component. The buttress componentincludes a buttress member and a plurality of circumferentially arrangedtabs extending proximally from the buttress member. The fastening memberis configured and dimensioned to engage the plurality ofcircumferentially arranged tabs to securely position the buttresscomponent on the staple cartridge component.

In an embodiment, the buttress member may have an annular configuration.In particular, the buttress member may be concentrically disposed in ajuxtaposed relation with the plurality of surgical staples. Thefastening member may be an annular ring configured and dimensioned toapply inward force to the plurality of circumferentially arranged tabsagainst an outer wall of the staple cartridge component. In addition,the fastening member may be a suture tied around the plurality ofcircumferentially arranged tabs against an outer wall of the staplecartridge component.

In another embodiment, the outer wall of the staple cartridge componentmay define a circumferential groove configured and adapted to receive aportion of the plurality of circumferentially arranged tabs. Thefastening member may be in registration with the circumferential groove.

The apparatus may further include a knife member concentrically arrangedin the staple cartridge component and with the buttress member. Theknife member may be movable relative to the staple cartridge component.In particular, the buttress member may be configured to be disposedradially outward of knife member.

The plurality of circumferentially arranged tabs may each define a lineof weakening adjacent the buttress member to enable detachment of thebuttress member from the plurality of tabs. The buttress component maybe configured such that the plurality of circumferentially arranged tabsengage an inner wall of the staple cartridge component.

In accordance with another embodiment of the present disclosure, thereis provided an apparatus for joining two hollow organ sections with anannular array of surgical staples. The apparatus includes a staplecartridge component, an anvil component, a buttress component, and afastening member. The staple cartridge component includes a plurality ofsurgical staples in an annular array. The anvil component is movablerelative to the staple cartridge component between spaced apart andapproximated positions to adjustably clamp the organ sections betweenthe staple cartridge and anvil components. The buttress component isconfigured and dimensioned to be positioned on a distal surface of thestaple cartridge component. In particular, the buttress componentincludes a buttress member and an outer rim extending proximally fromthe buttress member. The outer rim is configured and adapted to engagean outer wall of the staple cartridge component. The fastening member istied around the outer rim of the buttress component to secure the outerrim against the outer wall of the staple cartridge component.

In an embodiment, the outer rim may include a plurality ofcircumferentially arranged loops configured and adapted to receive thefastening member therethrough. Alternatively, the outer rim may define aplurality of circumferentially arranged apertures dimensioned to receivethe fastening member therethrough. Furthermore, each aperture mayinclude an adhesive to secure the fastening member therein. The outerrim may define a circumferential line of weakening adjacent the buttressmember to enable detachment of the buttress member from the outer rim.

In accordance with still another embodiment of the present disclosure,there is provided an apparatus for joining two hollow organ sectionswith an annular array of surgical staples. The apparatus includes astaple cartridge component, an anvil component, a knife member and abuttress component. The staple cartridge component includes a pluralityof surgical staples in an annular array. The anvil component defines aplurality of staple pockets for forming the surgical staples. The anvilcomponent is movable relative to the staple cartridge component betweenspaced apart and approximated positions to adjustably clamp the organsections between the staple cartridge and anvil components. The knifemember is concentrically arranged in the staple cartridge component. Theknife member is movable relative to the staple cartridge component. Thebuttress component includes a buttress member concentrically alignedwith the plurality of surgical staples and a plurality ofcircumferentially arranged tabs extending proximally from the buttressmember. The plurality of tabs and the staple cartridge component havecorresponding attaching members for securing the plurality of tabs tothe staple cartridge component.

In an embodiment, the attaching members may be hook and loop fasteners.In particular, the staple cartridge component may have the hook and loopfasteners on the outer wall thereof and the plurality of tabs may havethe corresponding hook and loop fasteners on an inner surface ofthereof. Alternatively, the staple cartridge component may have the hookand loop fasteners on an inner wall thereof and the plurality of tabsmay have the corresponding hook and loop fasteners on an outer surfaceof thereof.

In accordance with yet another embodiment of the present disclosure,there is provided an apparatus for joining two hollow organ sectionswith an annular array of surgical staples. The apparatus includes astaple cartridge component, an anvil component, a knife member and afirst buttress component. The staple cartridge component includes aplurality of surgical staples in an annular array. The anvil componentincludes an anvil member defining a plurality of staple pockets forforming the surgical staples and a shaft extending distally from theanvil member. The anvil component is movable relative to the staplecartridge component between spaced apart and approximated positions toadjustably clamp the organ sections between the staple cartridge andanvil components. The knife member is concentrically arranged in thestaple cartridge component. The knife member is movable relative to thestaple cartridge component. The first buttress component includes abuttress member concentrically aligned with the anvil component and arim extending distally from the buttress member. The first buttresscomponent encloses the plurality of staple pockets defined in the anvilmember.

The apparatus may further include a fastening member securing the firstbuttress component to the shaft of the anvil component. In particular,the fastening member may include a plurality of barbs. The rim of thefirst buttress component may be an outer rim that engages an outersurface of the anvil member. In addition, the first buttress componentmay further include an inner rim extending distally from the buttressmember. The inner rim may be configured and dimensioned to engage theshaft of the anvil component.

In an embodiment, the apparatus may further include a second buttresscomponent concentrically aligned with the staple cartridge component.The second buttress component may include a buttress member and aplurality of circumferentially arranged tabs extending proximally fromthe buttress member. The plurality of tabs may engage an outer wall ofthe staple cartridge component. In particular, the plurality of tabs andthe outer wall of the staple cartridge component may includecorresponding hook and loop fasteners to secure the second buttresscomponent to the staple cartridge component.

Each tab may include a line of weakening adjacent the buttress memberfor detachment of the buttress member from the plurality of tabs. Thebuttress component may be configured such that the plurality of tabsengage an inner wall of the staple cartridge component. The plurality oftabs and the inner wall of the staple cartridge component may includecorresponding hook and loop fasteners to secure the second buttresscomponent to the staple cartridge component.

The apparatus may further include a fastening member configured anddimensioned to engage the plurality of circumferentially arranged tabsto securely position the second buttress component on the staplecartridge component. The fastening member may be an annular ringconfigured and dimensioned to apply inward force to the plurality ofcircumferentially arranged tabs against an outer wall of the staplecartridge component. Alternatively, the fastening member may be a suturetied around the plurality of circumferentially arranged tabs against anouter wall of the staple cartridge component.

BRIEF DESCRIPTION OF THE DRAWINGS

Various embodiments of the present disclosure are described hereinbelowwith reference to the drawings, wherein:

FIG. 1 is a perspective view of an annular surgical stapling apparatusconfigured for use with a surgical buttress assembly in accordance withan embodiment of the present disclosure;

FIG. 2 is a perspective view of a head portion of the surgical staplingapparatus of FIG. 1 illustrating a surgical buttress assembly mounted ona distal portion of a staple cartridge assembly;

FIG. 3 is an exploded, perspective view, with parts separated, of thehead portion of FIG. 2;

FIG. 4 is an enlarged, cross-sectional view of the area of detailindicated in FIG. 2;

FIG. 5 is a perspective view of a head portion of a surgical staplingapparatus including a surgical buttress assembly in accordance withanother embodiment of the present disclosure;

FIG. 6 is an exploded, perspective view, with parts separated, of thehead portion of FIG. 5;

FIG. 7 is an enlarged, cross-sectional view of the area of detailindicated in FIG. 5;

FIG. 8 is a perspective view of the annular surgical apparatus of FIG. 1illustrating insertion of the apparatus through two hollow organsections;

FIG. 9 is an enlarged, partial longitudinal, cross-sectional view of thehead portion of the apparatus of FIG. 8;

FIG. 10 is an enlarged, partial longitudinal, cross-sectional view ofthe head portion of the apparatus of FIG. 8, illustrating stapling andcutting of the two hollow organ sections;

FIG. 11 is a perspective view of a head portion of a surgical staplingapparatus including a surgical buttress assembly in accordance withstill another embodiment of the present disclosure;

FIG. 12 is an exploded, perspective view, with parts separated, of thehead portion of FIG. 11;

FIG. 13 is an enlarged, cross-sectional view of the area of detailindicated in FIG. 11;

FIG. 14 is a perspective view of a head portion of a surgical staplingapparatus including a surgical buttress assembly in accordance withstill another embodiment of the present disclosure;

FIG. 15 is an exploded, perspective view, with parts separated, of thehead portion of FIG. 14;

FIG. 16 is an enlarged, cross-sectional view of the area of detailindicated in FIG. 14;

FIG. 17 is a perspective view of a head portion of a surgical staplingapparatus including a surgical buttress assembly in accordance withstill yet another embodiment of the present disclosure;

FIG. 18 is an exploded, perspective view, with parts separated, of thehead portion of FIG. 17;

FIG. 19 is an enlarged, cross-sectional view of the area of detailindicated in FIG. 17;

FIG. 20 is a perspective view of a head portion of a surgical staplingapparatus including a surgical buttress assembly in accordance withstill yet another embodiment of the present disclosure;

FIG. 21 is an exploded, perspective view, with parts separated, of thehead portion of FIG. 20;

FIG. 22 is an enlarged, cross-sectional view of the area of detailindicated in FIG. 20;

FIG. 23 is a perspective view of a head portion of a surgical staplingapparatus including a surgical buttress assembly in accordance withstill another embodiment of the present disclosure, illustrating ananvil assembly and the surgical buttress assembly detached from thesurgical stapling apparatus;

FIG. 24 is a perspective view of the anvil assembly and the surgicalbuttress assembly of FIG. 23 securely positioned on the anvil assembly;

FIG. 25 is an exploded, perspective view, with parts separated, of ahead assembly of a surgical stapling apparatus including a surgicalbuttress assembly in accordance with still yet another embodiment of thepresent disclosure; and

FIG. 26 is a perspective view of an anvil assembly and the surgicalbuttress assembly of FIG. 25 securely positioned on the anvil assembly.

DETAILED DESCRIPTION OF EMBODIMENTS

Embodiments of the present disclosure will now be described in detailwith reference to the drawings, in which like reference numeralsdesignate identical or corresponding elements in each of the severalviews. As used herein, the term “distal,” as is conventional, will referto that portion of the instrument, apparatus, device or componentthereof which is farther from the user while, the term “proximal,” willrefer to that portion of the instrument, apparatus, device or componentthereof which is closer to the user. In the following description,well-known functions or constructions are not described in detail toavoid obscuring the present disclosure in unnecessary detail.

With reference to FIG. 1, a surgical stapling apparatus 10 forperforming circular anastomosis of hollow organs is shown. Surgicalstapling apparatus 10 drives a circular array of staples 7 (FIG. 9)through the end sections of each organ and simultaneously fires acylindrical knife 76 (FIG. 9) to cores any tissue radially inward of thedriven circular array of staples 7 to free the tubular passage, andthereby joining two ends of the organ. Surgical stapling apparatus 10includes a handle assembly 20 having a pair of pivotable actuatinghandle members 22 and an advancing means 24 including a rotatable gripmember 26, an elongate body portion 30 extending distally from handleassembly 20, and a head portion 50 including an anvil assembly 60, astaple cartridge assembly 70, and a surgical buttress assembly 100 inaccordance with an embodiment of the present disclosure.

The components of surgical apparatus 10 are generally formed fromthermoplastics including polycarbonates, and metals including stainlesssteel and aluminum. The particular material selected to form aparticular component will depend upon the strength requirements of theparticular component. Staples 7 are of a conventional type and include abackspan having a pair of legs extending from the backspan. The legsterminate in tissue penetrating tips.

Handle assembly 20 can be actuated to approximate anvil assembly 60relative to staple cartridge assembly 70 and to apply a pair of annulararrays of staples 7 through tissue. In order to properly position tissuein head portion 50, rotatable grip member 26 may be rotated to moveanvil assembly 60 axially relative to staple cartridge assembly 70between a spaced apart position and an approximated position in whichanvil assembly 60 is positioned adjacent staple cartridge assembly 70 toclamp tissue therebetween. Handle members 22 may be squeezed to firestaples 7 through tissue to join two segments “T₁,” “T₂” (FIG. 9) oftubular tissues together, as will be discussed in detail below.

Elongate body portion 30 is constructed to have a slightly curved/bentshape along its length. However, elongate body portion 30 may also bestraight, as well as flexible to bend to any configuration. The length,shape and/or the diameter of elongate body portion 30 may be varied tosuit a particular surgical procedure.

With reference to FIGS. 2-4, head portion 50 includes anvil assembly 60,staple cartridge assembly 70 and surgical buttress assembly 100detachably secured with staple cartridge assembly 70. Staple cartridgeassembly 70 may be fixedly connected to a distal end portion of elongatebody portion 30 or may be configured to concentrically fit within thedistal end portion of elongate body portion 30. In particular, staplecartridge assembly 70 defines a pair of annular arrays of staplereceiving slots 72 having a staple 7 disposed in each one of staplereceiving slots 72 and a circumferentially arranged groove 71 (FIG. 4)such as, e.g., a countersink, in an outer wall 79 thereof.

In addition, staple cartridge assembly 70 includes cylindrical knife 76concentrically arranged with the pair of annular arrays of staples 7 anda plurality of staple pushers 9 (FIG. 9) each disposed in respectivestaple receiving slot 72 to eject the respective staple 7 through slot72. In use, staples 7 travel through slots 72 and tissue toward anvilassembly 60 for formation thereof.

With brief reference to FIG. 9, cylindrical knife 76 includes a distalrim 79 defining a knife blade adapted to cut tissue. Upon actuation ofhandle members 22, cylindrical knife 76 is moved distally to cut tissue,and the plurality of pushers 9 are moved distally to eject staples 7disposed in staple receiving slots 72 therethrough, toward anvilassembly 60.

With particular reference back to FIG. 3, positioned distally of staplecartridge assembly 70 is anvil assembly 60 including an anvil member 62and a shaft 64 extending proximally from anvil member 62. Anvil member62 includes a plurality of pockets (not shown) for receiving and formingstaples 7. Shaft 64 is configured to be detachably received inapproximation shaft 75 disposed in elongate body portion 30.Approximation shaft 75 is operatively coupled with rotatable grip member26 of handle assembly 20, whereby rotation of rotatable grip member 26moves approximation shaft 75 axially. Such axial movement ofapproximation shaft 75 is imparted to anvil assembly 60 detachablycoupled with approximation shaft 75. In this manner, anvil assembly 60is movable axially relative to staple cartridge assembly 70 between aspaced apart position and an approximated position in which anvilassembly 60 is positioned adjacent staple cartridge assembly 70 toadjustably clamp tissue between anvil assembly 60 and staple cartridgeassembly 70.

Examples of instruments for performing circular anastomosis of holloworgans are described in U.S. Pat. Nos. 6,053,390, 5,588,579, 5,119,983,5,005,749, 4,646,745, 4,576,167, and 4,473,077, each of which is herebyincorporated herein in its entirety by reference.

With continued reference to FIGS. 3 and 4, surgical buttress assembly100 includes a buttress component 110 and a fastening member in the formof an annular ring 130 configured and dimensioned to secure buttresscomponent 110 on staple cartridge assembly 70. Buttress component 110 isprovided to reinforce and seal staple lines applied to tissue bysurgical stapling apparatus 10.

Buttress component 110 includes a buttress member 112 having an annularprofile configured to be concentrically aligned with staple cartridgeassembly 70 and a plurality of circumferentially arranged tabs 120extending proximally from buttress member 112. In use, buttress member112 is mounted on a distal surface 74 of staple cartridge assembly 70.The annular profile of buttress member 112 is configured and dimensionedto be flush with an outer peripheral edge of staple cartridge assembly70 when mounted on staple cartridge assembly 70. Moreover, buttressmember 112 is superposed with the pair of annular arrays of staplereceiving slots 72. I'm not clear on what this means, what annulararrays? In this manner, when staples 7 are ejected through the pair ofannular arrays of staple receiving slots 72, the legs of each staple 7penetrate through buttress member 112 and the backspan of staple 7 issecured or abuts against a proximal surface of buttress member 112.

In addition, cylindrical knife 76 is disposed radially inward of annulararray of staple receiving slots 72 and of buttress member 112 that is ina superposed relation with the annular array of staple receiving slots72 so as to not extend across a knife path of cylindrical knife 76. Inthis manner, upon actuation of handle members 22, the entire buttressmember 112 is stapled to tissue to reinforce said tissue, and severingof buttress member 112 by cylindrical knife 76 is eliminated.

A fastening member is configured and dimensioned to engage the pluralityof circumferentially arranged tabs to securely position the buttresscomponent on the staple cartridge component of the stapling apparatus.For example, the plurality of circumferentially arranged tabs 120 thatextend proximally from buttress member 112 are positionable on distalsurface 74 of cartridge assembly 70. See FIG. 3. More particularly, aproximal end of each tab 120 extends proximal of a groove 71circumferentially defined in outer wall 79 of cartridge assembly 70. SeeFIG. 4.

The fastening member may be provided in the form of an annular ring 130,which is secured around circumferentially arranged tabs 120, such thatannular ring 130 applies a radially inward force against tabs 120disposed across groove 71. In this manner, annular ring 130 overliesgroove 71 and is substantially flush with portions of buttress member112 and/or tabs 120 that are disposed on or against outer wall 79 ofstaple cartridge assembly 70. Such configuration enables buttress member112 to be securely positioned in place with respect to staple cartridgeassembly 70.

Annular ring 130 may include and is not limited to a resilient band. Forexample, a piece of spring metal, which may be circular in shape, or alength of suture material, or similar straps, bands, cables, or othermembers may be used.

Buttress component 110 is monolithically formed as a single construct.However, each tab 120 may include a break, perforations, or a line ofweakening adjacent buttress member 112, whereby buttress member 112 thatis stapled to tissue may be severed or detached from the plurality oftabs 120. In this manner, tabs 120 may at least partially be retained ingroove 71 by annular ring 130 and later removed from the surgical sitealong with surgical stapling apparatus 10.

Buttress member 112 is fabricated from a biocompatible material which isbio-absorbable or non-absorbable, as well as natural or syntheticmaterials. It should be understood that any combination of natural,synthetic, bio-absorbable, and non-bioabsorbable materials may be usedto form buttress member 112.

In addition, buttress member 112 may be porous, non-porous, orcombinations thereof. It is also envisioned that buttress member 112described herein may contain a plurality of layers in which anycombination of non-porous and porous layers may be configured. Forexample, buttress member 112 may be formed to include multiplenon-porous layers and porous layers that are stacked in an alternatingmanner. In another example, buttress member 112 may be formed in a“sandwich-like” manner wherein the outer layers of buttress member 112include porous layers and the inner layers are non-porous layers.Examples of multi-layered buttress members are disclosed in U.S. PatentApplication Publication No. 2009/0001122, filed on Jun. 27, 2007,entitled “Buttress and Surgical Stapling Apparatus,” the entiredisclosure of which is incorporated by reference therein.

In particular, the use of non-porous layers in buttress member 112 mayenhance the ability of buttress member 112 to resist tears andperforations during the manufacturing, shipping, handling, and staplingprocesses. In addition, the use of a non-porous layer in the surgicalbuttress may also retard or inhibit tissue ingrowth from surroundingtissues, and thereby acting as an adhesion barrier and inhibiting theformation of unwanted scar tissue.

In addition, at least one bioactive agent may be combined with buttressmember 112. The agent may be disposed on a surface of the surgicalbuttress and/or impregnated therein. In these embodiments, buttressmember 112 can also serve as a vehicle for delivery of the bioactiveagent. The term “bioactive agent,” as used herein, is used in itsbroadest sense and includes any substance or mixture of substances thathave clinical use.

With reference now to FIGS. 5-7, it is further contemplated that asurgical buttress assembly 200 may include buttress component 110 and afastening member in the form of a suture 230. In contrast to surgicalbuttress assembly 100, suture 230 may be utilized to securely positionbuttress component 110 on a distal surface 274 of a staple cartridgeassembly 270. As described hereinabove, a proximal end of each tab 120extends across a groove 271 (FIG. 7) defined in an outer wall 279 ofcartridge assembly 270 when buttress member 112 is positioned on distalsurface 274 of staple cartridge assembly 270.

In use, suture 230 is wrapped around circumferentially arranged tabs120, such that suture 230 applies radially inward force against portionsof tabs 120 disposed at least partially across groove 271. Inparticular, staple cartridge assembly 270 defines groove 271 having anarcuate, transverse, cross-sectional profile to better accommodatesuture 230 that overlies groove 271, as shown in FIG. 7. Suchconfiguration enables buttress component 110 to be securely positionedin place with respect to staple cartridge assembly 270.

With reference to FIGS. 8-10, surgical stapling apparatus 10 is shown inuse in an anastomosis procedure to effect joining of, for example, twoopposing intestinal sections. The anastomosis procedure is typicallyperformed using minimally invasive surgical techniques includinglaparoscopic means and instrumentation. Initially, a diseased intestinalsection is removed. Thereafter, anvil assembly 60 is inserted to theoperative site either through a surgical incision or transanally and ispositioned within the intestinal section “T₁.” Elongate body portion 30of surgical stapling apparatus 10, including staple cartridge assembly70, is inserted transanally into the other intestinal section “T₂.” Theintestinal sections “T₁,” “T₂” are then temporarily secured about theirrespective components (e.g., shaft 64 of anvil assembly 60 and thedistal end of elongate body portion 30) by conventional means such as apurse string suture “P” (see FIG. 9).

Thereafter, the clinician maneuvers anvil assembly 60 until the proximalend of shaft 64 is inserted into and attached/connected to the distalend of approximation shaft 75 disposed in elongate body portion 30 ofsurgical stapling apparatus 10. Shaft 64 engages approximation shaft 75to be operable as a unitary construct. Anvil assembly 60 and elongatebody portion 30 are then approximated to approximate the intestinalsections “T₁,” T₂.” Surgical stapling apparatus 10 is then fired causingthe plurality of staple pushers 9 each disposed in respective staplereceiving slot 72 to eject the respective staple 7 through slot 72.Staples 7 travel through intestinal sections “T₁,” T₂,” as well asbuttress member 112, toward anvil assembly 60, thereby effectingstapling of intestinal sections “T₁,” T₂” to one another, whilecylindrical knife 76 cuts a portion of tissue disposed radially inwardof cylindrical knife 76 to complete the anastomosis. At this time, tabs120 remain attached to buttress member 112 stapled to the intestinalsections “T₁,” T₂” and are secured with staple cartridge assembly 70 byannular ring 130. Upon removal of surgical stapling apparatus 10 fromthe surgical site, the break or the line of weakening adjacent buttressmember 112 facilitates detachment of tabs 120 from buttress member 112stapled to intestinal sections “T₁,” T₂.”

With reference now to FIGS. 11-13, a buttress assembly 300 in accordancewith another embodiment of the present disclosure is shown. A fasteningmember is in the form of a suture 330. In particular, buttress component310 includes a buttress member 312 configured and dimensioned to bepositioned on a distal surface 374 of staple cartridge assembly 370 anda rim 320 extending proximally from an outer radial edge of buttressmember 312. Rim 320 engages an outer wall 379 of staple cartridgeassembly 370, whereby buttress component 310 encloses distal surface 374of staple cartridge assembly 370. A cylindrical knife 376 is disposedradially inward of buttress member 312, whereby under such aconfiguration severing of buttress member 312 by cylindrical knife 376is eliminated.

Rim 320 includes a plurality of circumferentially arranged loops 315.Each loop 315 is configured and dimensioned to accommodate a suture 330therethrough. Suture 330 is wrapped and tied around rim 320 through theplurality of loops 315 against outer wall 379 of staple cartridgeassembly 370 to secure buttress component 310 on staple cartridgeassembly 370. In addition, rim 320 includes a circumferentially definedbreak, plurality of perforations or line of weakening 316 adjacentbuttress member 312, whereby buttress member 312 that is stapled totissue may be detached from rim 320. In this manner, rim 320 that isdetached from buttress member 312 remains secured to outer wall 379 ofstaple cartridge assembly 370 by suture 330 and is removed from thesurgical site along with staple cartridge assembly 370. Alternatively,each loop 315 may be created by defining a pair of substantiallyadjacent slits in rim 320.

With reference to FIGS. 14-16, a buttress assembly 400 in accordancewith another embodiment of the present disclosure is shown. Buttressassembly 400 includes a buttress component 410 and a fastening member inthe form of a suture 430. In particular, buttress component 410 includesa buttress member 412 configured and dimensioned to be positioned on adistal surface 474 of staple cartridge assembly 470 and a rim 420extending proximally from an outer radial edge of buttress member 412.Rim 420 engages an outer wall 479 of staple cartridge assembly 470,whereby buttress component 410 encloses distal surface 474 of staplecartridge assembly 470.

In contrast to rim 320, rim 420 includes a plurality ofcircumferentially arranged apertures, holes or bores 415. Each bore 315is configured and dimensioned to receive suture 430 therethrough. Suture430 is looped and tied around rim 420 through the plurality of bores 415to secure buttress component 410 on staple cartridge assembly 470. Inaddition, rim 420 includes a break 416 circumferentially definedadjacent buttress member 412, whereby buttress member 412 that isstapled to tissue may be detached from rim 420. In this manner, rim 420that is detached from buttress member 412 is secured to outer wall 479of staple cartridge assembly 470 and is removed from the surgical sitealong with staple cartridge assembly 470.

It is further contemplated that each bore 415 may include an adhesive ora gel such as, e.g., hydrogel, to improve securement of suture 430 inbore 415. In addition, it is also envisioned that suture 430 may includea plurality of, e.g., unidirectional, barbs, to improve securement ofsuture 430 in bores 415. Examples of barbed sutures are disclosed inU.S. patent application Ser. No. 12/361,962, filed Jan. 29, 2009, theentire content of which is incorporated herein by reference. A compoundbarbed suture is available commercially as V-LOC™ from Tyco HealthcareGroup, LLP (dba Covidien AG, Mansfield, Mass.).

With reference to FIGS. 17-19, a buttress assembly 600 in accordancewith another embodiment of the present disclosure is shown. Buttressassembly 600 includes a buttress member 610 and a plurality ofcircumferentially arranged tabs 620 extending proximally from an outerradial edge of buttress member 610. Each tab 620 includes an attachingmember 630 a on an inner wall or surface 625 thereof.

Furthermore, outer wall 679 of staple cartridge assembly 670 includes aplurality of circumferentially arranged attaching members 630 bcorresponding to attaching members 630 a on tabs 620. Attaching members630 a, 630 b may include, for example, a refastenable tape or a hook andloop fastener. Alternatively, tabs 620 may include a double-sidedadhesive tape to detachably position buttress assembly 600 to staplecartridge assembly 670.

In addition, it is also envisioned that each tabs 620 may include abreak, perforations or a line of weakening 616, whereby buttress member610 that is stapled to tissue may be severed or detached from tabs 620.In this manner, tabs 620 may be secured with staple cartridge assembly670 by attaching members 630 a, 630 b and removed from the surgical sitealong with staple cartridge assembly 670.

With reference now to FIGS. 20-22, it is also contemplated that abuttress assembly 700 may include a buttress member 710 and a pluralityof circumferentially arranged tabs 720 extending proximally from aninner radial edge of buttress member 710 that engage an inner wall 777of staple cartridge assembly 770. In particular, each tab 720 includesan attaching member 730 a on an outer wall thereof. Furthermore, innerwall 777 of staple cartridge assembly 770 includes a plurality ofcircumferentially arranged attaching members 730 b corresponding toattaching members 730 a on tabs 720. Attaching members 730 a, 730 b mayinclude, for example, a refastenable tape or a hook and loop fastener.

Under such a configuration, cylindrical knife 776 is positioned radiallyinward of attaching members 730 b circumferentially arranged on innerwall 777 of staple cartridge assembly 770 and positioned radiallyoutward of attaching members 730 a on respective outer wall of each tab720. Under such a configuration, cylindrical knife 776 travels betweenattaching members 730 a, 730 b and severs tabs 720 from buttress member710. In addition, tabs 720 may include a break, perforations, or a lineof weakening 716 to facilitate severing of tabs 720 from buttress member710. In this manner, buttress member 710 that is stapled to tissue maybe detached from tabs 720.

With reference to FIGS. 23 and 24, a buttress assembly 800 in accordancewith another embodiment of the present disclosure is shown. In contrastto buttress assemblies 100, 200, 300, 400, 600, 700, describedhereinabove, buttress assembly 800 is configured and adapted to besecurely positioned with anvil assembly 60. Buttress assembly 800includes a buttress component 810. A suture 830 is used to attach thebuttress component to the stapling apparatus. Buttress component 810includes a buttress member 812 having an annular profile configured anddimensioned to be flush with an outer peripheral edge of anvil member 62when mounted on anvil member 62 and a rim 820 extending distally frombuttress member 812. In addition, rim 820 engages an outer wall 61 ofanvil member 62, whereby buttress component 810 encloses a proximalsurface of anvil member 62 defining the plurality of pockets forreceiving and forming staples 7. Additionally, buttress member 812defines an aperture, hole or bore 816 configured and dimensioned toreceive shaft 64 of anvil assembly 60 therethrough. Bore 816 isdimensioned to provide a friction and tight fit around shaft 64.Additionally or alternatively, a suture 830 may be further utilized tosecurely fasten buttress member 812 to shaft 64.

With reference to FIGS. 25 and 26, in an alternate embodiment a buttressassembly 900 includes a buttress member 912 radially extending betweenan outer rim 920 and an inner rim 940. In particular, outer rim 920 isconfigured and dimensioned to engage outer wall 61 of anvil member 62and inner rim 940 is configured and dimensioned to provide a tight orfriction fit against shaft 64 of anvil assembly 60. In this manner,radial and longitudinal movement of buttress assembly 900 with respectto anvil assembly 60 is minimized. In addition, a fastening member inthe form of a suture 930 is wrapped or tied around inner rim 940 ofbuttress member 912 against shaft 64 of anvil assembly 60 to furthersecure buttress assembly 900 on anvil assembly 60.

With continued reference to FIG. 25, buttress assembly 900 may be usedin conjunction with buttress assembly 100 that is positionable on distalsurface 74 of staple cartridge assembly 70, as well as any one ofbuttress assemblies 200, 300, 400, 600, 700, described hereinabove.Buttress assembly 100 is positioned radially outward of cylindricalknife 76. As such, upon actuation of handle members 22, the entirebuttress member 112 is stapled to tissue to reinforce the tissue, andsevering of buttress member 112 by cylindrical knife 76 is eliminated.However, cylindrical knife 76 cores a portion of buttress member 912along with inner rim 940 and suture 930 wrapped and tied around innerrim 940, to free such portions from a portion of buttress member 912that is also stapled to tissue. The use and operation of assemblies 200,300, 400, 600, 700, 800, 900 are substantially similar to the use andoperation of buttress assembly 100 described hereinabove, and thus willnot be described further herein.

Although the illustrative embodiments of the present disclosure havebeen described herein with reference to the accompanying drawings, theabove description, disclosure, and figures should not be construed aslimiting, but merely as exemplifications of particular embodiments. Forexample, buttress assembly 900 including buttress member 912 radiallyextending between inner rim 940 and outer rim 920 may be tailored foruse on distal surface 74 of staple cartridge assembly 70. In addition,buttress assembly 900 may further utilize an annular ring 130 or suture330 to secure outer rim 920 of buttress assembly 900 against outer wall61 of anvil assembly 60. It is to be understood, therefore, that thedisclosure is not limited to those precise embodiments, and that variousother changes and modifications may be effected therein by one skilledin the art without departing from the scope or spirit of the disclosure.

1. An apparatus for joining two hollow organ sections with an annulararray of surgical staples, the apparatus comprising: a staple cartridgecomponent including a plurality of surgical staples arranged in anannular array; an anvil component movable relative to the staplecartridge component between spaced apart and approximated positions toadjustably clamp the organ sections between the staple cartridge andanvil components; a buttress component configured and dimensioned to bepositioned on a distal surface of the staple cartridge component, thebuttress component including a buttress member and a plurality ofcircumferentially arranged tabs extending proximally from the buttressmember; and a fastening member configured and dimensioned to engage theplurality of circumferentially arranged tabs to securely position thebuttress component on the staple cartridge component.
 2. The apparatusaccording to claim 1, wherein the buttress component is configured suchthat the plurality of circumferentially arranged tabs engage an innerwall of the staple cartridge component.
 3. An apparatus for joining twohollow organ sections with an annular array of surgical staples, theapparatus comprising: a staple cartridge component including a pluralityof surgical staples in an annular array; an anvil component movablerelative to the staple cartridge component between spaced apart andapproximated positions to adjustably clamp the organ sections betweenthe staple cartridge and anvil components; a buttress componentconfigured and dimensioned to be positioned on a distal surface of thestaple cartridge component, the buttress component including a buttressmember and an outer rim extending proximally from the buttress member,the outer rim configured and adapted to engage an outer wall of thestaple cartridge component; and a fastening member tied around the outerrim of the buttress component to secure the outer rim against the outerwall of the staple cartridge component.
 4. The apparatus according toclaim 3, wherein the outer rim includes a plurality of circumferentiallyarranged loops configured and adapted to receive the fastening membertherethrough.
 5. The apparatus according to claim 3, wherein the outerrim defines a plurality of circumferentially arranged aperturesdimensioned to receive the fastening member therethrough.
 6. Theapparatus according to claim 8, wherein each aperture includes anadhesive to secure the fastening member therein.
 7. The apparatusaccording to claim 3, wherein the buttress member has an annularconfiguration, the buttress member disposed in a juxtaposed relationwith the plurality of surgical staples.
 8. The apparatus according toclaim 3, wherein the outer wall of the staple cartridge component has acircumferential groove configured and adapted to receive a portion ofthe outer rim therein.
 9. The apparatus according to claim 8, whereinthe fastening member is in registration with the circumferential groove.10. The apparatus according to claim 3, further comprising a knifemember concentrically arranged in the staple cartridge component andwith the buttress member, the knife member movable relative to thestaple cartridge component.
 11. The apparatus according to claim 10,wherein the buttress member is configured to be disposed radiallyoutward of the knife member.
 12. The apparatus according to claim 3,wherein the outer rim defines a circumferential line of weakeningadjacent the buttress member to enable detachment of the buttress memberfrom the outer rim.